Dr. Chapa’s Clinical Pearls. New Intrapartum FHT Guidance: Oct 2025 CPG 10
Sep 21, 2025
Explore the evolution of electronic fetal monitoring from the 1960s to today, highlighting its role in intrapartum care despite limitations. Discover three key points from the upcoming ACOG guidelines, including the relevance of intermittent fetal auscultation. Delve into maternal oxygen use for fetal resuscitation and the emerging potential of AI in fetal heart rate assessments. The discussion underscores gaps in evidence while emphasizing best practices for monitoring and resuscitation.
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Continuous Monitoring Is Widespread But Limited
- Continuous electronic fetal monitoring is ubiquitous but has not reduced perinatal death or long-term neurological injury.
- It mainly increases interventions while preventing some immediate neonatal seizures.
When To Use Intermittent Auscultation
- Use intermittent auscultation only for low-risk patients not on oxytocin and without prior cesarean.
- Prefer continuous monitoring for ease, reproducibility, and when risk factors exist.
Rapid Response Saved A Severely Acidotic Preterm Baby
- Dr. Chapa described a 29-week patient with severe preeclampsia and a textbook category III tracing who delivered within 20 minutes.
- The baby had pH 6.9 and base excess −20 but was resuscitated and doing well after the rapid C-section.